The Diagnostic Rate and Phonetic Characters of Benign Vocal Fold Lesions with Sulcus

Ahn, Cheol Min; Moon, Ko Jeong; Kim, Mi Ra; Woo, Won Keun; Kim, Seong Tae

Abstract

BACKGROUND AND OBJECTIVES
It is not uncommon in patients with benign vocal fold lesions with voice change to accompany sulcus. The authors postulated that the coexistence of such benign lesions with sulcus would result in numerous problems related with phonation. The aim of this study was to recognize through voice analysis any particular phonation characteristics in patients with benign vocal fold lesions with coexisting sulcus, and to aid in diagnosis and treatment. MATERIALS AND METHOD: The study involved 574 patients who had been diagnosed with benign vocal fold lesions that accompanied voice change from Jan. 2001 through Sept. 2002. The diagnosis was made by videostroboscopy. The benign vocal fold lesions were observed in patients with sulcus and those without sulcus. Also specific benign vocal fold lesions were grouped into pairs determined by the existence of sulcus. Thus, patients with vocal nodules accompanied with sulcus were grouped as group NS and those without sulcus as group N: similarly, patients with vocal polyp and sulcus were grouped as PS and those without sulcus as group P: patients with Reinke's edema and sulcus as group RS and those without sulcus as group R, and patients with laryngeal edema and sulcus were grouped as group LS and without sulcus as group L. Each individual group went through psychoacoustic, acoustic and aerodynamic analyses and were compared against each other. RESULTS: Among patients with benign vocal fold lesions, about 50.2% had sulcus. It was observed that the rate of finding patients with sulcus increased when we began to have keen interest in sulcus. Among patients with benign vocal fold lesions without the accompaniment of sulcus, the most common form of benign vocal fold lesions was the vocal nodule. With coexisting sulcus, the most common form was laryngeal edema. In the psychoacoustic analysis group, the group NS exhibited more hoarseness than the group N: the group R exhibited greater hoarseness than the group RS. However, these results did not have statistical significance. In the acoustic analysis, the group NS had significantly higher shimmer score than the group N. In the aerodynamic analysis, the group NS and PS had exhibited significanlyt higher MFR scores than the groups N and P. CONCLUSIONS: The existence of sulcus in patients with benign vocal fold lesions has a clinical significance regarding treatment and prognosis. Although some acoustic analytic references may be useful in discovering the accompanying sulcus, careful observation of all vocal cords remains the most important component of such discoveries.